Ventera was awarded a multi-year contract with the Centers for Medicare & Medicaid Services (CMS) to redesign iQIES—the Internet Quality Improvement and Evaluation System. As a mission-critical application, iQIES manages patient and provider information nationwide, ensuring the delivery of high-quality healthcare. Every hospital, caregiver, and home health service in the U.S. is federally mandated to use this system, making its reliability and usability essential.
A year into the project, the team faced significant challenges. Process inefficiencies, shifting requirements, and strained client relationships had derailed progress. That’s when I was brought in—to lead an 18-person research and design team, establish strategic processes, and rebuild trust with CMS. My mission was clear: transform a struggling SAFe Agile program into a high-functioning, user-centered operation that delivered measurable results.
The design team was filled with talented, intelligent, and committed professionals who cared deeply for their mission. While the team itself was brilliant, it was disjointed and lacked vision, a clear strategy, and the tools to help it become more efficient and effective. The team and I needed to align research and design, bridge gaps between design and development, and create more efficient end-to-end processes.
Likewise, the client possessed a low UX maturity and lacked a basic understanding of the necessity of research and design. Due to poor process and lack of measurable outcomes, there was a genuine erosion of trust and confidence that needed to be repaired to be successful moving forward.
The research team was the most experienced group, but they lacked proper inputs to observe and test. They had almost no quantitative data to help inform their research and complete the picture. I created a plan to:
Unfortunately, both were impossible to implement due to government regulations. We needed a new strategy and to scale back on inputs and capabilities. Working with our new product manager, he and I planned and pitched a way forward using Google Analytics on small test environments. While we could not learn from the existing old and antiquated system, we would gain valuable insights into users going forward.
Our second focus was to create more user touchpoints through on-site trips for the team to tour facilities, shadow users, and conduct small focus group interviews. So, we drew up plans for travel, cost, and projected outcomes and convinced the client to allow the touchpoints on a limited basis.
After interviewing designers, researchers, and our content strategist, there was low engagement between the team members, each entrenched within their own camps. I started having researchers and designers pair up with one another, each focused on their own user stories. I then realized the wide communication gap between design and devs and created a weekly sync for the teams to converse, work through issues, and build a shared understanding. Much of this stemmed from design’s lack of knowledge of what was possible and what was not. They needed a better and more efficient way to work together.
This led to two significant initiatives that created greater efficiency and increased time to value—a prototyping framework and a design system. The team had migrated to Sketch, so we started the prototyping framework there, quickly building out the atomic assets that would go into building the design system. The prototyping framework helped the team build and test designs with users and developers.
I added two front-end devs to my team to work primarily on the design system. Several issues arose during the project, including personnel and disputes amongst the greater dev team. This threatened the future of the design system and ultimately derailed the efforts, which had to be rebooted down the road. The groundwork of this effort went on to help create the basis for Ventera’s VStart Framework, which was a selling point to clients for quicker program starts from prebuilt assets.
Our team and I had some significant wins, including earning the highest ux team maturity rating ever given by the Centers for Medicare and Medicaid’s Human-centered Design Center of Excellence. We also increased research inputs by over 300% and increased prototyping and development speeds by nearly double. This led to greater efficiencies and an understanding by the business that the company needed pliable assets to help kick off future programs quicker and with greater accuracy and efficiency.
On a personal level, my leadership skills were put to the test on this program. I had several personnel issues that created large fissures within the team and added to conflict with the client. While these were manageable, they were untimely and came at significant costs to the program and team morale.
I was also pushed to a barely sustainable level managing 18 individuals, including some early-career hires who required additional care and attention. Unfortunately, some of the most seasoned professionals on the team also needed the extra focus. When you support too many individuals, it becomes unsustainable, and something inevitably falls through the cracks.
Overall, I am proud of the high-performing team we built together, honored I was able to work with and supoprt them, and grateful for the experience that challenged me in new and creative ways.